The primary goal of this grant is to evaluate the effect of computerization of the nursing process on both the efficiency of the nurse and the quality of patient care. The nursing process as has been defined includes the planning, implementation, documentation and the evaluation of patient care. The underlying hypothesis is that care will be improved when the nursing process accurately and timely follows patient specific care plans developed by both physician and nursing staff. To study the effects of computerization, computer programs have been developed to computerize the planning, documentation, and evaluation of care. These programs have been written to interact in such a manner that the correlation between the planning and documentation databases is always maintained. To accomplish this, the care plan program determines the data to be charted while the charting program reconciles those nursing actions requested by the care plan. This design should insure the optimal use of both the care plan and the chart. The implementation and evaluation of this system will be the prime task of the grant. The design of the evaluation includes a pre- and post-implementation study together with a case and control study. Two ICUs have been designated as test units for a pre- and post-study and two ICUs will serve as control units. One nursing division will serve as a test unit with a second division serving initially as a control unit and subsequently as a test unit. A third nursing division will serve only as a control unit. Measurements of nursing efficiency, compliance, and attitudes, and the effect of the system on patient care will be made.